【摘要】 研究脑胶质瘤热疗后超微结构的改变 ,探讨热疗联合平阳霉素早期化疗的临床应用方法及疗效。　　方法　应用透射电镜观察 1 0例脑胶质瘤用双极电凝器热疗后超微结构的改变 ;观察热疗联合平阳霉素局部及全身早期化疗治疗 2 0例脑胶质瘤患者的疗效 ,并与同期手术的 2 0例脑胶质瘤患者比较 ,均行随访。　　结果　热疗后肿瘤细胞膜结构损伤 ,线粒体、内质网等细胞器膨胀 ,线粒体嵴消失 ,胞浆稀疏等。随访 3 6～ 58个月 ,热化疗组肿瘤复发比例为 8/ 2 0 ,平均复发时间为 2 2 4个月 ,1年、2年、3年的生存比例分别为 1 9/ 2 0、1 5/ 2 0及 1 3 / 2 0 ,平均生存时间 3 9 4个月 ,疗效显著优于对照组。　　结论　热疗可损伤肿瘤细胞膜结构和线粒体等 ;双极电凝热疗治疗脑胶质瘤是安全和有效的 ;热疗与平阳霉素具有协同抗肿瘤作用更多还原

【Abstract】 Objective To research the change of ultra-structure in glioma after hyperthermia and the therapeutic effects of hyperthermia in combination with pingyangmycin early chemotherapy. Methods The ultra-structure of glioma before and after hyperthermia in 10 cases was observed by electromicroscopy (TEM). 20 patients with malignant and recurrent glioma had been treated by the method of hyperthermia with bipolar electrocoagulator and early pingyangmycin intracranially and intravenously. The therapeutic effects were followed up. Results After heated to 43℃ for 30 minutes, the structure of cell memberance of glioma was indistinct, partly broken, cytoplasm spared, mitochondria expanded and the crest of mitochondria disappeared, endoplasmic reticulum enlarged. The results of the follow up cases (following up 36-58 months) had demonstrated that the tumor recurrent rate was 8/20. The recurrent mean time was 22.4 months. One year survival rate was 19/20, two years 15/20 and three years 13/20, the survival mean time 39.4 months. The therapeutic effects in the thermochemotherapic group were superior to those of the control group. Conclusions The mechanism of hyperthermia anti-tumor effect was that heat could injury directly to the structure of cell membrane and mitochondrian. It was convenient, effective and safe that the method of hyperthermia with bipolar-electrocoagulator to treat patients with glioma. It was possible to combine hyperthermia with pingyangmycin chemotherapy in order to enhance anti-tumor effects.更多还原